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Comparative study of coronary collaterals in diabetic and nondiabetic patients by angiography
1Department of Cardiology, National Institute of Cardiovascular Diseases, Sher E Bangla Nagar, Dhaka 1207.
Insights
Diabetic patients with coronary artery disease exhibit significantly poorer coronary collateral development compared to non-diabetic individuals. This impacts blood flow restoration after myocardial ischemia.
Area of Science:
- Cardiology
- Vascular Biology
- Diabetology
Background:
- Myocardial ischemia's severity is linked to coronary collateral formation, but variability exists.
- The influence of diabetes mellitus (DM) on coronary collateral development remains unclear.
- Understanding these factors is crucial for managing ischemic heart disease.
Purpose of the Study:
- To investigate the effect of diabetes mellitus on the development of coronary collaterals in patients with coronary artery disease.
- To compare collateralization between diabetic and non-diabetic patients undergoing coronary angiography.
Main Methods:
- Prospective case-control study (January-December 2000) at NICVD, Dhaka.
- Included patients with coronary artery disease (CAD) and <=75% stenosis in at least one coronary artery.
- Case group: diabetic patients with CAD (n=36); Control group: non-diabetic patients with CAD (n=50), matched for risk factors.
Main Results:
- No significant differences in clinical characteristics between groups.
- Diabetic patients had a higher mean number of diseased vessels (2.6 vs. 2.1).
- Mean collateral score was significantly lower in the diabetic group (0.5) compared to the non-diabetic group (1.2).
Conclusions:
- Coronary collateral development is significantly impaired in diabetic patients with CAD.
- Diabetes mellitus negatively impacts the body's ability to form compensatory blood vessels in response to ischemia.
- Further research is needed to elucidate mechanisms and therapeutic implications.
Abstract:
Myocardial ischaemia is known to be significantly related to the development of coronary collaterals, but there are considerable variations in their formation. The nature of this variability is not well understood. Likewise it remains unclear whether diabetes mellitus. DM has any effect on coronary collaterals. The aim of this study was to evaluate the effect of diabetes mellitus on coronary collaterals. This prospective case- control study was done from January to December 2000 in patients undergoing coronary angiography in National Institute of Cardiovascular Diseases (NICVD), Dhaka, who fulfilled the inclusion criteria of having < or = 75% stenosis in at least one coronary artery. The patients with diabetes having CAD without other modifiable major risk factors (hypertension, smoking, dyslipidaemia) were constituted case study group (n=36) and nondiabetic patients having CAD with those risk factors were constituted control group (n=50). Coronary collaterals were graded according to Rentrope scoring system and the collateral score was calculated by summing the Rentrope number of every patient. There was no statistical difference between patients with and without diabetes in clinical characteristics. The mean number of diseased vessel in DM group 2.6+/-0.6 was higher than that in nondiabetic patients (2.1+/-0.8, P>.05). The mean collateral score was 0.5+/-0.6 in DM group and 1.2+/-1.0 in nondiabetic group. These findings suggest that coronary collateral development is significantly poorer in diabetic than on diabetic patients.
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